Claims Processing
With one year left, it's time to chart your map to the new code set. And given that so many payers and providers are lagging behind recommended timelines, these tactics will help you get organized.
According to the KISS principle, most systems work best if they're kept simple. Simplicity is the key goal in design, and unnecessary complexity should be avoided. Clinical documentation improvement and ICD-10 preparation are no exception.
With an annual rate of 11,000 fatalities from falls in U.S. hospitals, falls are a persistent concern for healthcare facilities. They raise issues of care quality and are increasingly a financial issue.
A Mississippi health system and three hospitals in Texas, Indiana and Alabama are illustrating how hospitals can thrive in a tough economic environment. The facilities recently won awards for their leadership in initiatives to improve financial sustainability and achieve significant financial performance improvements.
Using automation technology to create an engaging payment experience for patients enables providers to see measurable operational and financial improvements including fewer days in accounts receivable, improved cash collections and reduced past-due accounts.
With patients paying more out-of-pocket costs and exchanges increasing the number of plans providers deal with, having financial counselors in a practice may become a necessity.
Even though it has not been determined what impact the health insurance exchanges will have on hospital finances, there are steps hospitals can take to increase the likelihood of positive effects on their revenue cycles.
Medicare announced Friday that it was revising rules intended to prevent the agency from paying twice for the same prescriptions for seniors receiving hospice care. The drug categories in question were identified in a 2012 investigation by the HHS inspector general.
If your modus operandi is to appeal all denied claims, you may want to reconsider because some claims are not worth it.
One of the worst failures of the Affordable Care Act is that, even with subsidies, the premiums and out-of-pocket expenses are unaffordable for far too many people. Unfortunately, a new proposal for catastrophic plans with very high deductibles would make accessing healthcare truly unaffordable for even more people.